Healthcare Provider Details

I. General information

NPI: 1679288807
Provider Name (Legal Business Name): LOVE IN ACTION (LIA) HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2023
Last Update Date: 01/23/2023
Certification Date: 01/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1127 QUEENSDOWN WAY
FORNEY TX
75126-3579
US

IV. Provider business mailing address

1127 QUEENSDOWN WAY
FORNEY TX
75126-3579
US

V. Phone/Fax

Practice location:
  • Phone: 336-471-3394
  • Fax:
Mailing address:
  • Phone: 336-471-3394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SAMMY O AYODELE
Title or Position: PROGRAM MANAGER
Credential: RN
Phone: 336-471-3394